crossing96/oncoscreening huggingface dataset:
Bladder cancer mortality and private well use in New England: an ecological study.	STUDY OBJECTIVE: To investigate the possible relation between bladder cancer mortality among white men and women and private water use in New England, USA, where rates have been persistently raised and use of private water supplies (wells) common. DESIGN: Ecological study relating age adjusted cancer mortality rates for white men and women during 1985-1999 and proportion of persons using private water supplies in 1970. After regressing mortality rates on population density, Pearson correlation coefficients were computed between residual rates and the proportion of the population using private water supplies, using the state economic area as the unit of calculation. Calculations were conducted within each of 10 US regions. SETTING: The 504 state economic areas of the contiguous United States. PARTICIPANTS: Mortality analysis of 11 cancer sites, with the focus on bladder cancer. MAIN RESULTS: After adjusting for the effect of population density, there was a statistically significant positive correlation between residual bladder cancer mortality rates and private water supply use among both men and women in New England (men, r = 0.42; women, r = 0.48) and New York/New Jersey (men, r = 0.49; women, r = 0.62). CONCLUSIONS: Use of well water from private sources, or a close correlate, may be an explanatory variable for the excess bladder cancer mortality in New England. Analytical studies are underway to clarify the relation between suspected water contaminants, particularly arsenic, and raised bladder cancer rates in northern New England.	bladder
Expectant treatment of small, recurrent, low-grade, noninvasive tumors of the urinary bladder.	Low-grade, noninvasive tumors of the bladder pose little threat to the patient. The standard treatment is removal by transurethral resection or cautery when they are identified. Once a patient has a history of low-grade papillary tumors and a subsequent low-grade appearing tumor, there is no urgency to proceed with treatment. The growth rate of these tumors is slow and they rarely progress.	bladder
Transitional cell carcinoma associated with marijuana: case report and review of the literature.	Transitional cell carcinoma of the bladder tends to occur in older patients with a history of tobacco use. We recently evaluated and treated a 45-year-old man with a history of heavy marijuana use. The patient's only risk factor for transitional cell carcinoma was the inhalation of up to five marijuana cigarettes daily for more than 30 years. We present our case and review the literature.	bladder
Neurovascular preservation in female orthotopic radical cystectomy significantly improves sexual function.	Radical cystectomy has emerged as a standard treatment option for patients with muscle invasive bladder cancer. The impact of nerve-sparing cystectomy with urethra and vaginal sparing has not been quantified with validated questionnaires. We report our experience with nerve-sparing orthotopic radical cystectomy and the impact on postoperative sexual function.	bladder
Value of clusterin immunoreactivity as a predictive factor in muscle-invasive urothelial bladder carcinoma.	OBJECTIVES: To determine whether clusterin immunoreactivity of muscle-invasive bladder carcinoma can predict disease-related survival of patients treated by radical cystectomy. METHODS: Multi-tissue arrays were constructed from 132 tumors and stained immunohistochemically using a mouse monoclonal antibody (clone 7D1). Positive clusterin staining was defined as immunoreactivity in more than 10% of tumor cells. We also studied tumor proliferation (Ki-67 antigen), p53, and Her2 expression. Immunoreactivity was compared with disease-related survival. Univariate and multivariate analyses were performed. RESULTS: Positive immunohistochemical clusterin expression was found in 25% of the tumors. On univariate analysis, clusterin immunoreactivity (P = 0.048), tumor stage (P = 0.011), nodal status (P = 0.0001), sex (P = 0.039), Ki-67 antigen index (P = 0.011), and Her2 expression (P = 0.020) were significantly associated with disease-related survival. On multivariate analysis, tumor stage (P = 0.01), nodal status (P = 0.0001), Ki-67 antigen (P = 0.0001), and Her2 expression (P = 0.001) were identified as significant independent predictive factors; clusterin expression missed the level of statistical significance by only a narrow margin (P = 0.058). CONCLUSIONS: Although clusterin immunoreactivity showed only a trend towards an independent prognostic relevance in this study, we conclude that it may be used, in addition to conventional and other immunohistochemical prognosticators, as a supplementary tool to provide more prognostic information in patients undergoing cystectomy for muscle-invasive bladder cancer.	bladder
Association between marijuana use and transitional cell carcinoma.	OBJECTIVES: Marijuana smoking has been implicated as a causative factor in traditionally tobacco-related tumors of the head and neck and of the lung. When associated with marijuana use, such tumors occur in a much younger patient population than do similar tumors in tobacco smokers. Owing to the large number of young men with a history of marijuana presenting with transitional cell carcinoma to VA facilities, this study was designed to compare the marijuana use among young (aged less than 60 years) transitional cell carcinoma patients with that among age-matched controls. METHODS: Fifty-two men aged less than 60 years presenting consecutively with transitional cell carcinoma and 104 age-matched controls (defined by having no history of transitional cell carcinoma, hematuria, or irritative voiding symptoms, as well as unremarkable results on urinalysis and urine cytology) completed questionnaires about exposure to various potential carcinogens, including radiation, Agent Orange, smoked or processed meats, dyes, tobacco, and marijuana. RESULTS: Of the 52 transitional cell carcinoma patients, 46 (88.5%) reported a history of habitual marijuana usage, and 72 (69.2%) of the age-matched controls gave a history of habitual marijuana use. This difference was statistically significant (P = 0.008). In those with transitional cell carcinoma, marijuana use significantly correlated with tumor stage, grade, and number of recurrences. CONCLUSIONS: Marijuana smoking might increase the risk of transitional cell carcinoma.	bladder
Novel technique for management of distal ureter and en block resection of bladder cuff during hand-assisted laparoscopic nephroureterectomy.	OBJECTIVES: To report our experience with a novel flexible cystoscopic approach to excise the en block bladder cuff and juxtavesical ureter during hand-assisted laparoscopic nephroureterectomy. The optimal technique for excising the distal ureter and bladder cuff during nephroureterectomy continues to evolve. METHODS: Hand-assisted laparoscopic nephroureterectomy was performed in 6 patients. A hand-assist device and two 5 to 12-mm ports were placed in the mid and upper abdomen. Two 10-mm clips were placed on the proximal ureter to occlude it, and the kidney was resected in the usual fashion. An additional 5 to 12-mm port was placed in the midline between the umbilicus and symphysis pubis. The ureter was dissected down into the pelvis to the level of the bladder. Without repositioning the patient, a flexible cystoscope was inserted into the bladder and a 2-cm bladder cuff excised using a 5F electrode on cutting current, with coagulating current used as needed. The specimen was removed intact through the hand port. RESULTS: The mean time to resect the distal bladder cuff was 30 minutes (range 22 to 35). The mean estimated blood loss was 254 mL. The mean operating room time was 264 minutes, mean hospital stay 6.3 days, and mean time to a general diet 2.6 days. All patients underwent cystography at 7 to 10 days postoperatively, with no extravasation or diverticula. Cystoscopic and computed tomography follow-up demonstrated no evidence of recurrence. CONCLUSIONS: This technique allows for complete resection of the kidney, distal ureter, and a cuff of bladder, avoiding repositioning.	bladder
Infrequent microsatellite instability in urothelial cell carcinoma of the bladder in young patients.	OBJECTIVE: Defects in the DNA mismatch repair result in microsatellite instability (MSI), which characterise most tumours related to the hereditary non-polyposis colorectal cancer syndrome and some sporadic tumours. Several studies have reported the occurrence of MSI in urothelial cell carcinoma (UCC) of the bladder with a particularly high incidence in tumours from young patients. In this study, we have evaluated the occurrence of MSI in primary bladder UCC arising in seventeen young patients selected for being below 45 years of age at diagnosis. METHODS: Microsatellite analysis has been performed using the panel of five quasimonomorphic mononucleotide repeats (BAT-25, BAT-26, NR-21, NR-24, NR-27) recently recommended to detect MSI tumours. The original Bethesda panel including BAT-25, BAT-26 and three dinucleotide repeats (D2S123, D5S346, D17S250) has further been studied in 10 UCC samples. RESULTS: MSI has been observed in only one of the 17 bladder UCC studied. Using the original Bethesda panel, identical results were obtained, indicating that the panel of five mononucleotide markers adequately detected MSI in UCC tumours. CONCLUSIONS: Our data indicate that classical MSI affecting mono- or di-nucleotides are rarely involved in bladder UCC developing in young patients. Further studies using gold standard criteria would help clarifying the involvement of MSI in the pathogenesis of bladder UCC.	bladder
FGFR3 and p53 protein expressions in patients with pTa and pT1 urothelial bladder cancer.	AIMS: This study is designed to evaluate the expression and prognostic value of FGFR3 protein expression in patients with pTa/pT1 tumours and to determine the significance of the combinations of FGFR3 and p53 protein expressions in bladder pathogenesis. MATERIALS AND METHODS: A tissue microarray (TMA) of 107 pTa, and 147 pT1 tumours was constructed. The TMA sections were immunostained with FGFR3 and p53 monoclonal antibodies. RESULTS: There were significant associations between loss of FGFR3 and tumour stage (p<0.001) and grade (p<0.001) and between p53 overexpression and tumour stage and grade (p<0.001 and p<0.001, respectively). There was no association between FGFR3 and p53 proteins (p=0.107). In addition, tumours with FGFR3+/p53- phenotype have slower recurrence rate than other (FGFR3+/p53+, FGFR3-/p53- and FGFR3-/p53+). CONCLUSION: 1-FGFR3 expression is significantly associated with two important prognostic factors; stage and grade. 2-FGFR3 protein expression is not an independent predictive factor for pTa/pT1 tumour recurrence and progression. 3-Tumours with FGFR3+/p53- phenotype seem to have a distinctive pathway in bladder tumorigenesis.	bladder
The transcripts of SFRP1,CEP63 and EIF4G2 genes are frequently downregulated in transitional cell carcinomas of the bladder.	OBJECTIVE: The aim of the present study was to identify differentially expressed genes that might be associated with the phenotype of superficial and invasive bladder cancer. METHODS: Differential display reverse transcriptase PCR (DDRT-PCR) was used to compare the expression pattern between normal bladder tissue and 4 groups of transitional cell carcinomas of the bladder regarding clinical stage and grade. RESULTS: We were able to identify 72 different transcripts, of which 57 (79%) showed homology to known genes, 12 (17%) to hypothetical proteins and 3 (4%) to human expressed sequence tags. Among the differentially expressed genes, SFRP1,CEP63 and EIF4G2 were further validated by quantitative RT-PCR in a series of 50 transitional cell carcinomas. Overall, the transcripts of these three genes were shown to be downregulated in the bladder tumors analyzed. In accordance with the DDRT-PCR results, the SFRP1 transcripts were shown to be downregulated in 90% (45/50) of the bladder tumors as compared with the normal bladder tissue. Although EIF4G2 and CEP63 transcripts exhibited three different expression patterns, downregulation was found in about 50% of the cases analyzed. In addition, downregulation of both CEP63 and EIF4G2 gene transcription was associated with invasive tumors. CONCLUSION: The use of DDRT-PCR analysis to compare expression patterns among different subgroups of bladder tumors allowed us to identify a significant number of genes implicated in different cellular pathways that, when up- or downregulated, might play a role in the tumorigenic process of the bladder.	bladder
Changes in the upper urinary tract after radical cystectomy and urinary diversion: a comparison of antirefluxing and refluxing orthotopic bladder substitutes and the ileal conduit.	PURPOSE: We evaluated and compared the effects of different types of urinary diversion on functional and radiographic changes in the upper urinary tract. MATERIALS AND METHODS: We analyzed data on 275 patients who underwent radical cystectomy and urinary diversion for bladder cancer and were observed at least 12 months. Of the patients 197 received an orthotopic bladder substitute, including antirefluxing ureteral anastomoses in 111 (group 1) and refluxing ureteral anastomoses in 86 (group 2). Ileal conduits were created in 78 patients (group 3). Serial serum Cr, radiographic changes in the upper urinary tract after diversion and the number of episodes of APN were compared by diversion method. Mean followup was 52 months (range 12 to 174 months) with no difference among the groups. RESULTS: Compared with group 3 patients in groups 1 and 2 demonstrated a significantly higher incidence of moderate to severe hydronephrosis (p = 0.001) but the incidence was similar between groups 1 and 2 (6.3%, 8.3% and 1.4% of the renal units in groups 1 to 3, respectively). Stabilized postoperative Cr did not differ among the groups. CRF, defined as Cr 3.0 mg/dl or greater, occurred in 2.7% of the patients in group 1 and in 3.5% of those in group 2 but in none in group 3. APN was noted in 3.3%, 4.4% and 0.4% of patients in groups 1 to 3, respectively (p = 0.012). CONCLUSIONS: An ileal conduit with a lower rate of diversion related hydronephrosis, CRF and morbidity associated with APN was superior to orthotopic bladder substitutes. Between the refluxing and antirefluxing types of orthotopic bladder substitutes no significant difference in functional or radiographic changes was noted.	bladder
Effect of preoperative delay on survival in patients with bladder cancer undergoing cystectomy in Quebec: a population based study.	PURPOSE: In Canada there is growing concern that waiting time for cancer surgery has been increasing. We used population based data to estimate the average PD for RC in Quebec and assess whether delayed surgery has a negative impact on long-term survival. MATERIALS AND METHODS: We used the provincial billing database of the maladie du Quebec to identify all patients with bladder cancer 18 years or older who underwent RAMQ from 1990 to 2002. PD was calculated as the time elapsed between the most recent transurethral resection and the date of RC. Patients were categorized according to PD tertiles into 3 groups, namely 1) 20 or less, 2) 21 to 47 and (C) 48 days or greater. Cox proportional hazards models were used to assess the effect of PD on overall survival, while adjusting for patient and provider factors. RESULTS: During the study period 1,592 radical cystectomies were performed. Overall median PD was 33 days (95% CI 30 to 35). Median PD increased from 23 days in 1990 to 50 in 2002. After adjusting for calendar year, and patient and provider variables there were no significant differences in survival among the 3 delay categories. However, patients subject to greater than 12 weeks of delay were at 20% greater risk for dying (95% CI 1.0 to 1.5, p = 0.051). CONCLUSIONS: In line with previous reports PD greater than 12 weeks seems to be associated with a worse long-term prognosis.	bladder
Evidence for alternative candidate genes near RB1 involved in clonal expansion of in situ urothelial neoplasia.	In this paper, we present whole-organ histologic and genetic mapping studies using hypervariable DNA markers on chromosome 13 and then integrate the recombination- and single-nucleotide polymorphic sites (SNPs)-based deletion maps with the annotated genome sequence. Using bladders resected from patients with invasive urothelial carcinoma, we studied allelic patterns of 40 microsatellite markers mapping to all regions of chromosome 13 and 79 SNPs located within the 13q14 region containing the RB1 gene. A whole-organ histologic and genetic mapping strategy was used to identify the evolution of allelic losses on chromosome 13 during the progression of bladder neoplasia. Markers mapping to chromosomal regions involved in clonal expansion of preneoplastic intraurothelial lesions were subsequently tested in 25 tumors and 21 voided urine samples of patients with bladder cancer. Four clusters of allelic losses mapping to distinct regions of chromosome 13 were identified. Markers mapping to the 13q14 region that is flanked by D13S263 and D13S276, which contains the RB1 gene, showed allelic losses associated with early clonal expansion of intraurothelial neoplasia. Such losses could be identified in approximately 32% bladder tumor tissue samples and 38% of voided urines from patients with bladder cancer. The integration of distribution patterns of clonal allelic losses revealed by the microsatellite markers with those obtained by genotyping of SNPs disclosed that the loss within an approximately 4-Mb segment centered around RB1 may represent an incipient event in bladder neoplasia. However, the inactivation of RB1 occurred later and was associated with the onset of severe dysplasia/carcinoma in situ. Our studies provide evidence for the presence of critical alternative candidate genes mapping to the 13q14 region that are involved in clonal expansion of neoplasia within the bladder antecedent to the inactivation of the RB1 gene.	bladder
Management of stage T1 tumors of the bladder: International Consensus Panel.	The International Consensus Panel on T1 bladder tumors markers reviewed the subject from a clinical perspective. From diagnosis to treatment decisions, what are the important issues in the management of a new patient? The assessment of prognostic factors for progression requires optimal resection and documentation. The role of immediate adjuvant intravesical chemotherapy after resection remains controversial. How often should the upper tract be assessed for tumor recurrence? The decision on whether to attempt bladder conservation with intravesical therapy or to perform a cystectomy is the most difficult issue in the management of superficial bladder cancer today. Finally, what therapies exist if initial intravesical bacille Calmette-Guérin fails to eradicate the disease or prevent recurrence? The panel thoroughly explored all these subjects and has made recommendations with supporting evidence.	bladder
Inhibition of bladder tumor growth by 1,1-bis(3'-indolyl)-1-(p-substitutedphenyl)methanes: a new class of peroxisome proliferator-activated receptor gamma agonists.	1,1-Bis(3'-indolyl)-1-(p-substitutedphenyl)methanes containing p-trifluoromethyl (DIM-C-pPhCF3), p-t-butyl (DIM-C-pPhtBu), and phenyl (DIM-C-pPhC6H5) substituents have been identified as a new class of peroxisome proliferator-activated receptor gamma (PPARgamma) agonists that exhibit antitumorigenic activity. The PPARgamma-active C-DIMs have not previously been studied against bladder cancer. We investigated the effects of the PPARgamma-active C-DIMs on bladder cancer cells in vitro and bladder tumors in vivo. In this study, the PPARgamma-active compounds inhibited the proliferation of KU7 and 253J-BV bladder cancer cells, and the corresponding IC50 values were 5 to 10 and 1 to 5 micromol/L, respectively. In the less responsive KU7 cells, the PPARgamma agonists induced caveolin-1 and p21 expression but no changes in cyclin D1 or p27; in 253J-BV cells, the PPARgamma agonists did not affect caveolin-1, cyclin D1, or p27 expression but induced p21 protein. In KU7 cells, induction of caveolin-1 by each of the PPARgamma agonists was significantly down-regulated after cotreatment with the PPARgamma antagonist GW9662. DIM-C-pPhCF3 (60 mg/kg thrice a week for 4 weeks) inhibited the growth of implanted KU7 orthotopic and s.c. tumors by 32% and 60%, respectively, and produced a corresponding decrease in proliferation index. Treatment of KU7 cells with DIM-C-pPhCF3 also elevated caveolin-1 expression by 25% to 30%, suggesting a role for this protein in mediating the antitumorigenic activity of DIM-C-pPhCF3 in bladder cancer.	bladder
Evaluation for surrogacy of end points by using data from observational studies: tumor downstaging for evaluating neoadjuvant chemotherapy in invasive bladder cancer.	PURPOSE: In clinical cancer trials for evaluating neoadjuvant chemotherapy, tumor downstaging is frequently used as a surrogate end point for overall survival. We evaluated the surrogacy of tumor downstaging using data from a follow-up observational study in bladder cancer. EXPERIMENTAL DESIGN: A total of 586 patients (from 32 Japanese hospitals) who underwent radical cystectomy for invasive bladder cancer (clinical T2 to T4) between 1990 and 2000 were analyzed. We considered changes over time in clinical stage at diagnosis and pathologic stage at cystectomy as a surrogate end point, and survival time after cystectomy as a true end point. First, we developed a new criterion for tumor downstaging. Second, we statistically evaluated surrogacy for the criterion using Prentice's criteria. RESULTS: To develop the criterion of end points based on tumor downstaging, we selected the best classification among all possible classifications in an attempt to separate prognosis for patients. The hazard ratios after adjustment for prognostic factors in the intermediate effect patients and the poor effect patients were 1.9 (95% confidence interval, 1.0-3.7) and 5.0 (95% confidence interval, 2.6-9.8), respectively, compared with that in the good effect patients. The conditions for correlation and conditional independency of Prentice's criteria were satisfied approximately. Neoadjuvant chemotherapy has a statistically significant tumor downstaging effect, whereas there was no difference on survival between treatment groups. CONCLUSIONS: The tumor downstaging effect could be an appropriate intermediate end point for screening novel neoadjuvant chemotherapy for invasive bladder cancer. The dataset from follow-up studies were useful for evaluating the surrogacy of end points.	bladder
[Chemoradiation in bladder cancer].	Bladder cancer is an urologic common tumor after prostate carcinoma. Radical treatment of localized invasive tumor is based on cystectomy. Surgical mutilation could be important when Bricker's urinary derivation is performed. Moreover, delated metastasis appeared frequently in spite of radical surgery. So, for selected patients, chemoradiotherapy is a valid alternative treatment to cystectomy. Cisplatin or derivatives were administered concurrently to radiation therapy up to 60-65 Gy. Patients underwent control cystoscopy at midtime of treatment in order to select responders from non responders. This review summarizes the main published series of radiochemotherapy in invasive bladder cancer. Results for local control, survivals, bladder preservation rates and toxicity are presented.	bladder